Many Physicians ‘Slow’ To Adopt Standard Care-Management Practices, Study Finds
Many physicians are "slow" to adopt standard care-management practices, "reflecting a large gap between medical knowledge and clinical practice," a problem that many researchers and large health care purchasers consider a "critical factor in both cost and quality woes infecting the health care system," according to a study published in the current issue of the Journal of the American Medical Association, the Wall Street Journal reports. The study, conducted by researchers at the University of Chicago, surveyed 1,040 medical groups nationwide with at least 20 physicians to determine their use of 16 care-management practices -- such as guidelines linked to medical records, patient registries, prescription renewal reminders and automatic prescription drug interaction monitors -- in the treatment of patients with chronic diseases. According to the study, the medical groups on average used five of the care-management practices, and 16% of the groups used none of the practices. The study also found low investment in clinical information systems by the medical groups; 50% of the groups did not have one of the seven features on their data systems about which researchers asked, such as routine access to laboratory results. According to Lawrence Casalino, one of the study's researchers, many physicians do not adopt standard care-management practices because of cost. "It costs money to create these programs and maintain them," Casalino said, adding, "Most doctor groups aren't going to do it if they have no way to get that money back." In addition, many physicians consider the practices "cookbook medicine" with "little scientific validity" and a "challenge to their autonomy," the Journal reports (Winslow, Wall Street Journal, 2/4). An abstract of the study is available online.
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